Step 2 Ck Psychiatry

Front 1

what are the RF for suicide?

Back 1

SAD PERSONS
Sex (male)
Age (older)
Depression
Previous attempt
Ethanol/substance
abuse
Rational thought
Sickness (chronic
illness)
Organized plan
No spouse
Social support lacking

Front 2

management of a patient who is trying to commit suicide?

Back 2

A patient who endorses suicidality requires emergent inpatient hospitalization
even against his will.

Front 3

when is suicide an increase risk?

Back 3

Suicide risk ↑ after antidepressant therapy

Front 4

who attempts to commit suicide more male or female? who is more likely to succeed?

Back 4

Women are more likely to attempt
suicide, whereas men are more likely to succeed by virtue of their ↑ use of
more lethal methods.

Front 5

what is Pain disorder and what is it associated with?

Back 5

Intensity or profile of pain symptoms is inconsistent with physiologic processes. More common in females. May be associated with depression

Front 6

Bulimia Nervosa is more common in what gender? and what is it associated with?

Back 6

More common among women; associated with low self-esteem and OCD.

Front 7

signs and symptoms of a patient with bulimia nervosa?

Back 7

bingeeating and compensatory behaviors that include purging or fasting.
■ Patients are ashamed and conceal their behaviors.
■ Signs include dental enamel erosion, enlarged parotid glands, and scars on the dorsal hand surfaces (from inducing vomiting).

Front 8

Tx. for bulimia nervosa?

Back 8

Psychotherapy and Antidepressants

Front 9

Tx for anorexia nervosa

Back 9

Rx:
■ Initially, monitor caloric intake to stabilize weight; then focus on
weight gain.
■ Hospitalize if necessary to restore nutritional status and correct electrolyte
imbalances.
■ Once the patient is medically stable, initiate individual, family, and
group psychotherapy. Treat comorbid depression and anxiety.

Front 10

criteria for Substance abuse

Back 10

requires ≥ 1 of the following in one year:
■ Failure to fulfill responsibilities.
■ Use in physically hazardous situations.
■ Legal problems during the time of substance use

Front 11

Substance dependence require what of the following?

Back 11

requires ≥ 1 of the following in one year:
■ Tolerance and using progressively larger amounts to obtain the same
desired effect.
■ Withdrawal symptoms when not taking the substance.
■ Failed attempts to abstain from the substance.
■ Significant time spent obtaining the substance.
■ Isolation from life activities.

Front 12

tourette's syndrome: more common in what gender, associated with what?

Back 12

More common in males; shows a genetic predisposition. Associated with
ADHD, learning disorders, and OCD

Front 13

signs and symptoms of tourett's

Back 13

multiple motor (e.g.,
blinking, grimacing) and vocal (e.g., grunting, coprolalia) tics occurring many times per day, recurrently, for > 1 year.

Front 14

tx for tourett's

Back 14

haloperidol, pimozide, or clonidine

Front 15

tx. for learning disabilities

Back 15

Rx: Interventions include remedial classes or individualized learning
strategies.

Front 16

treatment for autism spectrum disorders

Back 16

Intensive special education, behavioral management, and symptomtargeted
medications.
■ Family support and counseling are crucial.

Front 17

how is ADD diagnosed?

Back 17

Diagnosis requires ≥ 6 symptoms from each category for ≥ 6 months in at
least two settings → significant social and academic impairment. Some
symptoms must be present in patients before age seven

Front 18

Tx for ADD

Back 18

Methylphenidate, Antidepressants (e.g., SSRIs, nortriptyline, bupropion) and α2-agonists
(e.g., clonidine).

Front 19

Evolution of EPS:
4 hours:
4 days:
4 weeks:
4 months:

Back 19

4 hours: Acute dystonia
4 days: Akinesia
4 weeks: Akathisia
4 months: Tardive
dyskinesia

Front 20

tx for personality disorders

Back 20

TREATMENT
■ Psychotherapy is the mainstay of therapy.
■ Pharmacotherapy is reserved for cases of comorbid mood, anxiety, or psychotic
disorders.

Front 21

Tardive dyskinesia tx

Back 21

Discontinue or ↓ dose of neuroleptic,
Giving
anticholinergics or decreasing neuroleptic
may initially worsen tardive dyskinesia.

Front 22

Dyskinesia tx

Back 22

Give an anticholinergic (benztropine) or
rigidity). dopamine agonist (amantadine). Decrease
dose of neuroleptic or discontinue (if tolerated).

Front 23

Akathisia

Back 23

↓ neuroleptic and try β-blockers
(propranolol). Benzodiazepines or
anticholinergics may help.

Front 24

TCA toxicity—Tri-C’s:

Back 24

Convulsions
Coma
Cardiac arrhythmias

Front 25

Symptoms of mania

Back 25

DIG FAST
Distractibility
Insomnia (↓ need for
sleep)
Grandiosity (↑ selfesteem)/
more Goal
directed
Flight of ideas (or racing
thoughts)
Activities/psychomotor
Agitation
Sexual indiscretions
Talkativeness

Front 26

what is atypical depression

Back 26

Weight gain, hypersomnia, rejection sensitivity.

Front 27

management of delirium

Back 27

■ Treat underlying causes (delirium is often reversible).
■ Normalize fluids and electrolytes.
■ Optimize the sensory environment.
■ Use low-dose antipsychotics (e.g., haloperidol) for agitation and psychotic
symptoms.
■ Use physical restraints if necessary

Front 28

most common cause of delirium in the elderly?

Back 28

occult UTI is common in the elderly; check UA

Front 29

management of phobias

Back 29

■ Desensitization through incremental exposure to the feared object or
situation.

Front 30

tx for performance anxiety for social phobia

Back 30

SSRIs, low-dose benzodiazepines, or β-blockers

Front 31

what is panic disorder associated with?

Back 31

depression, agoraphobia, generalized anxiety, substance abuse

Front 32

tx. for OCD

Back 32

Rx: Pharmacotherapy (clomipramine or SSRIs
cognitive-behavioral therapy (CBT)

Front 33

GAD tx

Back 33

Rx: Lifestyle changes, psychotherapy, medication. SSRIs, venlafaxine, and
buspirone are most often used

Front 34

tx. of GAD acute symptoms

Back 34

Benzodiazepines may be
used for immediate symptom relief.